Using eZIS of SPECT to evaluate the therapeutic effect of carotid endarterectomy

Objective 

Stroke is an acute cerebrovascular disease with high morbidity and mortality. The main causes of ischemic stroke include carotid artery stenosis, and carotid endarterectomy (CEA) can be used to improve the blood flow of the lesion site. Regional cerebral blood flow (rCBF) can be decreased by using single photon emission computed tomography (SPECT). The Easy Z-Score imaging system (eZIS) can display the changes of rCBF as Z-Score. The purpose of this study was to determine whether eZIS of SPECT can be used to evaluate the therapeutic effect of CEA in the treatment of carotid artery stenosis.

Methods 

In this study, subjects were divided into the surgery group and the control group. The surgery group included seven patients with unilateral or bilateral internal carotid artery stenosis who received CEA treatment, and the control group included 11 patients who only received conventional drug treatment but did not receive surgery. Cerebral perfusion imaging (CPI) was collected twice before and after the corresponding treatment (within 6 months). rCBF of the lesion site was measured and Z-score was calculated before and after treatment by the eZIS technique.

Results 

The postoperative Z-score of the surgery group was 0.54 ± 2.71 compared with that of the preoperative −1.34 ± 2.68 (P = 0.0034; t = 4.687; df = 6), while the z-score of the control group was −0.33 ± 2.58 compared with that of the pretreatment 1.84 ± 2.62 (P = 0.0010; t = 4.618; df = 10).

Conclusion 

CEA can effectively improve the blood flow in the lesion area of patients with carotid artery stenosis. eZIS of SPECT can be used to evaluate the therapeutic effect of CEA on carotid artery stenosis visually.

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